PURPOSE: The pecten band can be defined as a fibrous tissue on the lowermost part of internal anal sphincter and may cause anal outlet obstruction, but its role is debatable. We evaluated the functional roles of the pecten band in hemorrhoids patients. METHODS: Three hundred sixteen hemorrhoids patients who underwent operations from January 1998 to April 2003 were analyzed for anal function according to presence or absence of a pecten band by using anorectal manometry and the constipation score. RESULTS: The numbers of males and females were 167 and 149. The overall pecten band positive was 63.6% (201/316), and pecten band positive was 84.6% (33/39) in patients who had previous anal surgery while it was 60.6% (168/277) in patients who had no history of surgery (P= 0.002). Pure hemorrhoids patients showed an 18.3% positive rate while patients with hemorrhoids and other conditions, such as anal fissure, fistula, or stricture, showed a 95.7% positive rate (P=0.00). Maximal resting anal pressures (mmHg, Mean+/-SD) and constipation score were 78.9+/-24.7 and 7.88+/-3.8 in the positive group and 67.1+/-22.2 and 4.55+/-2.8 in the negative group (P=0.00, 0.00). Postoperatively, the constipation score decreased significantly from 7.25 to 2.82 (P=0.003). CONCLUSIONS: The pecten band seems to be associated with anal outlet obstruction, and a pecten band releasing operation may be considered according to its presence or absence.
Anal Canal ; Constipation ; Constriction, Pathologic ; Female ; Fissure in Ano ; Fistula ; Hemorrhoids* ; Humans ; Male ; Manometry ; Pecten*

No abstract available.
Diagnosis* ; Hirschsprung Disease* ; Manometry*

Cavernous hemangioma in the gastrointestinal tract is a rare benign vascular lesion, which can produce massive or persistent blood loss. Herein, we present two cases of gastrointestinal hemangiomas that could not be resected completely and were treated with estrogen because of multiple involvement of the gastrointestinal tract and viscera, including the anal canal. A 49-year-old male presented with unknown chronic melena and anemia. Preoperative work-up could not reveal the definite cause of bleeding. During exploration, hemangioma scattered in whole small bowel was identified and feeding vessel ligation was performed. Postoperative recurrent bleedings were controlled by additional estrogen therapy. A 25-year-old young woman had suffered from painless anal bleeding with subsequent anemia since her youth. She had diffuse carvernous hemangioma in the large intestine involving the anal canal and uterus. Total proctocolectomy and ileal-pouch anal anastomosis was performed, however the uterine hemangioma was left intact because the patient wanted to be pregnant. She was also treated with estrogen, postoperatively. It is suggested that estrogen may be a good alternative treatment modality for gastrointestinal hemangioma that can not be removed completely.
Adolescent ; Adult ; Anal Canal ; Anemia ; Estrogens ; Female ; Gastrointestinal Tract ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Intestine, Large ; Ligation ; Male ; Melena ; Middle Aged ; Uterus ; Viscera

Saponin has been known to be a major antioxidant component in panax ginseng. Recent experimental study suggests that some antioxidant materials prevent Parkinson's disease caused by 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) in an animal model. The present study was performed to demonstrate the effect of ginseng saponins in the Parkinson's disease model induced by MPTP. To verify the effect of ginseng saponin on dopaminergic neurons in the mice brain, the tyrosine hydroxylase-immunoreactive (TH-ir) neurons were observed by immunohistochemical stain and immunoelectron microscopy (preembedding method). Also, in order to estimate the immunoreactivity of dopaminergic neuropils, they were quantified by image analysis. The number of TH-ir neurons of substantia nigra was significantly increased in the high-dose (0.46 mg/kg) ginseng saponin group compared with the MPTP injected group. The immunoreactivity of TH-ir neuropils in striatum was significantly increased in both high and low-dose (0.1 mg/kg) ginseng saponin groups compared with the MPTP injected group. In immunoelectron microscopic observation, TH-ir neurons of the control and both ginseng saponin injected group showed normal nuclei and well preserved cytoplasmic organelles. In the MPTP injected group, dying dopaminergic neurons showed destroyed nuclei and cytoplasmic organelles. These results suggest that ginseng saponin has a protective effect on the Parkinson's disease model induced by MPTP.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; Animals ; Brain ; Cytoplasm ; Dopaminergic Neurons* ; Mice* ; Microscopy, Immunoelectron ; Models, Animal ; Neurons ; Neuropil ; Organelles ; Panax* ; Parkinson Disease* ; Saponins* ; Substantia Nigra ; Tyrosine ; Tyrosine 3-Monooxygenase

Tailgut cyst is a rare congenital lesion in retrorectal space. The clinical significance of tailgut cyst presents its morbidity that occurs in the unrecognized and incompletely treated lesion. A forty four year-old female patient visited with lower abdominal pain during defecation. Preoperative abdominopelvic MRI and endorectal ultrasonography revealed a retrorectal mass suggestive of leiomyoma, dermoid cyst, teratoma, or duplication cyst of rectum. She underwent complete resection of retrorectal mass by transsphincteric approach. The mass was multilocular cyst lined by multiple types of epithelium. It was histologically confirmed as a tailgut cyst. She recovered uneventfully. This report includes the case and a brief review of tailgut cyst.
Abdominal Pain ; Defecation ; Dermoid Cyst ; Epithelium ; Female ; Humans ; Leiomyoma ; Magnetic Resonance Imaging ; Rectum ; Teratoma ; Ultrasonography

No abstract available.
Empyema, Tuberculous* ; Lymphoma, Non-Hodgkin* ; T-Lymphocytes*

Acalculous cholecystitis is an inflammation of the gallbladder in the absence of gallstones. Diagnosing this condition is often difficult because of the patient's debilitated medical condition and because of the limitation of biliary imaging technique. Nonetheless, its recognition and therapy are critically important, for if left untreated, many patients will die. During 10 years and 6 months from January 1986 to June 1996, 52 patients underwent assessment and treatment for acalculous cholecystitis at the Department of Surgery, Kyungpook National University Hospital. A clinical analysis of those patients was done and the following results were obtained: The incidence rate was 3.5%. The most prevalent age group was the seventh decade (13cases), and the male-to-female ratio was 1.4 : 1. Possible etiologic factors were found in 25 cases (48.1%). These factors were surgery in 5 cases (9.6%), trauma in 5 cases (9.6%), sepsis in 5 cases (9.6%), clonorchiasis in 5 cases (9.6%), and others in 5 cases(9.6%). Neither Ascariasis nor Salmonellosis was found as a predisposing factor in this study.The main cardinal symptoms and physical signs were similar to those of calculous cholecystitis. The sensitivities of diagnostic imaging by ultrasonography and computed tomography were 88.4% and 100%, respectively. Of the 52 patients, 46 cases underwent cholecystectomy, and 6 cases were initially treated by percutaneous transhepatic cholecystostomy. Of these 6 cases, two patients had cholecystostomies during subsequent abdominal operations for other conditions. Two patients had the cholecystostomy tube removed 2 months after an uneventful recovery and have had no further biliary problems. The other two patients died. The operative findings were cholecystitis only in 26 cases (56.5%), cholecystitis with localized peritonitis in 18 cases (39.1%), and cholecystitis with generalized peritonitis in 2 cases (4.3%). Postoperative complications occurred in 16 cases (34.8%), and wound infection was the most common complication (62.5% of all complications).The overall mortality was 9.6%. Conclusively, acalculous cholecystitis had high morbidity and mortality in this study. Once the diagnosis of acalculous cholecystitis is made, the gallbladder should be drained or removed. A decision as to the best approach depends on the specific situation and will require close cooperation between the internist, the surgeon, and the radiologist.
Acalculous Cholecystitis* ; Ascariasis ; Causality ; Cholecystectomy ; Cholecystitis ; Cholecystostomy ; Clonorchiasis ; Diagnosis ; Diagnostic Imaging ; Gallbladder ; Gallstones ; Gyeongsangbuk-do ; Humans ; Incidence ; Inflammation ; Mortality ; Peritonitis ; Postoperative Complications ; Salmonella Infections ; Sepsis ; Ultrasonography ; Wound Infection

PURPOSE: The purpose of this study was to compare the efficacy of curative emergency surgery for complicated colon cancer in terms of tumor recurrence and survival compared with that of elective surgery. METHODS: A total of 238 primary surgeries for colon cancer were performed. All patients were deemed to have undergone a curative resection. Patients were classified into an emergency surgery group for complicated colon cancers (n=40) and an elective surgery group for uncomplicated colon cancers (n=198). RESULTS: Emergency colonic cancers present at a more advanced stage (P=0.002). The postoperative mortality rate in the emergency group was significantly higher than it was in the elective group (15.0% vs. 2.5%, P= 0.004). There were differences between the two groups in tumor recurrence (32.5% vs. 13.1%, P=0.003), overall survival (52.5% vs. 71.7%, P=0.017), and disease-free survival (50.0% vs. 69.7%, P=0.016). However, after the patients were stratified according to tumor stage, no statistical differences were observed. CONCLUSIONS: When compared with uncomplicated colon cancers, complicated colon cancers present at a more advanced stage with a higher postoperative mortality and an overall worse prognosis. However, the difference decreases when patients are stratified according to the tumor stage. The negative prognostic efficacy of emergency surgery for complicated colon cancers appears to be confined to the perioperative period. Despite the more advanced stage of tumors in patients undergoing emergency surgery, the aim of the surgeon should be to offer a curative resection for better survival, if possible.
Colon* ; Colonic Neoplasms* ; Disease-Free Survival ; Emergencies* ; Humans ; Mortality ; Perioperative Period ; Prognosis ; Recurrence

PURPOSE: The purpose of this study was to compare outcomes for surgical treatment with those for medical treatment of GB dyskinesia. METHODS: Retrospective analysis of medical records and telephone interviews of 67 patients diagnosed with GB dyskinesia was done at Pohang St. Mary's Hospital between January 2004 and December 2009. Group 1 (n=18) patients received laparoscopic cholecystectomy. Group 2 (n=49) patients received medical treatment. GB dyskinesia was the diagnosis if the patient had typical biliary colic symptoms without GB stones or other GI disease, and if the ejection fraction was less than 35% on Tc-99m-DISIDA scans. RESULTS: The average age of patients diagnosed with GB dyskinesia was 45.8 years old. The sex ratio was 15:52 (male:female). The average symptom duration was 25.4 days. All had RUQ and, or epigastric pain. There were no significant between group differences in age, sex ratio, symptom duration, symptoms, follow up period, and ejection fraction. In group 1, patient symptoms improved after treatment in 16 cases (88.9%); in group 2, patient symptoms improved in 19 cases (38.8%). Surgical treatment was significantly more effective than medical treatment. The reasons for choosing medical treatment were predominantly the preference of the doctors. CONCLUSION: Surgical treatment is a more effective treatment for GB dyskinesia than medical treatment. Therefore, laparoscopic cholecystectomy should be considered as the 1st line treatment of choice for GB dyskinesia.
Biliary Dyskinesia ; Cholecystectomy, Laparoscopic ; Colic ; Dyskinesias ; Follow-Up Studies ; Gallbladder ; Humans ; Interviews as Topic ; Medical Records ; Retrospective Studies ; Sex Ratio